title: Factors influencing adolescents' decision not to smoke.
abstract: OBJECTIVE
  Although adolescents ultimately make their own decisions to smoke or not to smoke, social, economic, and environmental circumstances shape their choices. Most research on prevention of youth tobacco use focuses on predictors of smoking initiation. In this study, we explored nonsmoking attitudes, beliefs, and norms from the perspective of 16-17-year-old nonsmokers.
  
  
  METHODS
  This qualitative study targeted nonsmoking youths because most social policy in the arena of tobacco prevention aims to support adolescents who are tobacco free.
  
  
  METHODS
  Participants were 39 nonsmokers recruited from youth organizations in an urban community and included 22 African Americans (12 females; 10 males) and 17 Caucasian Americans (10 females; 7 males).
  
  
  METHODS
  A health behavior framework guided the development of semistructured questions on attitudes, beliefs, and norms associated with nonsmoking, used in eight in-depth group interviews.
  
  
  RESULTS
  Concerns for health and addiction, a positive self-image, and perceived confidence, emerged as factors affecting participants' decisions not to smoke. The approval of parents and friends, and personal beliefs further reinforced adolescents' nonsmoking decisions.
  
  
  CONCLUSIONS
  There were more commonalities than differences in nonsmoking attitudes across gender and race. Future studies of youth tobacco prevention should employ multifaceted approaches targeting adolescents' attitudes, families, and peer networks.
authors.affiliation: Department of Family and Community Mental Health Systems and Public Health Sciences, University of Virginia School of Nursing, Charlottesville, VA 22908, USA. pk6c@virginia.edu
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kulbok
authors.forename: Hyekyun
authors.initials: H
authors.lastname: Rhee
authors.forename: Nisha
authors.initials: N
authors.lastname: Botchwey
authors.forename: Ivy
authors.initials: I
authors.lastname: Hinton
authors.forename: Viktor
authors.initials: V
authors.lastname: Bovbjerg
authors.forename: Nancy Lois Ruth
authors.initials: NL
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012907:Smoking / Q000523:psychology*; D012927:Social Control, Informal; D011795:Surveys and Questionnaires; D014768:Virginia